Access to evidence-based psychosocial interventions for adults with attention-deficit/hyperactivity disorder (ADHD) remains limited, despite strong patient demand for nonpharmacological options such as cognitive behavioral therapy (CBT). Digital interventions may offer a scalable, low-threshold solution to meet this need and complement existing care. This pragmatic randomized controlled trial evaluated the effectiveness of attexis, a fully self-guided digital intervention based on CBT and mindfulness principles, as an adjunct to treatment as usual (TAU). A total of 337 adults with confirmed ADHD were randomized to either attexis + TAU or TAU alone. The primary outcome was ADHD symptom severity (Adult ADHD Self-Report Scale total score) at 3 months post-randomization (T1). Secondary outcomes included functional impairment, depressive symptoms, self-esteem, and health-related quality of life. Follow-up was conducted at 6 months (T2). Intent-to-treat analyses showed significantly lower ADHD symptom severity in the intervention group at T1 (baseline-adjusted mean difference = −5.0 points; d = 0.85, p < .001). Significant improvements were also observed across all secondary outcomes, and effects remained stable at T2. Responder analyses confirmed the clinical relevance of the findings. Subgroup analyses demonstrated consistent effects across sex, medication use, psychotherapy status, and treatment changes. No adverse events related to attexis were reported. attexis was effective in reducing ADHD symptoms and improving a broad range of functional and psychosocial outcomes. As a safe, low-threshold, fully self-guided intervention, it may serve as a valuable adjunct to routine care and help address existing gaps in access to psychosocial treatment for adults with ADHD.

Digital technologies provide a convenient and scalable approach to dietary assessment and personalised feedback, facilitating behaviour change. This is essential for reducing the prevalence of non-communicable diseases at a population level. However, the evaluation of the acceptability and feasibility of dietary feedback delivered via online platforms has not been thoroughly investigated. By utilising the term ‘system architecture’ to describe the essential components of the digital approach to capturing dietary feedback, this systematic review outlines the platform, dietary assessment methodology, reference values for assessing dietary intake and elements of personalised dietary feedback. When reported, the acceptability and feasibility of personalised feedback were captured. OVID Medline, OVID Embase, Scopus via Elsevier and Cinahl Plus via EBSCO identified 5839 studies. Search terms included dietary assessment, feedback and digital technologies. In total, twenty-eight studies involving 301 271 participants were included. Food frequency questionnaires were the most commonly used dietary assessment method, accessed via web-based platforms. Dietary intake was commonly assessed using a diet quality index, and feedback was provided on food groups, often combined with a diet quality score or macronutrient analysis. While participant acceptance of personalised dietary feedback was generally high, the overall completion rates for acceptability questionnaires were low, and feasibility was seldom reported. Methods used to measure acceptability and feasibility varied, preventing comparisons across studies. Study quality was high; however, future research would benefit from the involvement of stakeholders and end-users in designing feedback messages.

Mobile health (mHealth) interventions offer promising ways to enhance access and continuity of mental health services in low-resource settings. However, little is known about the perspective of end users in routine primary care in Nigeria regarding the role of mHealth in mental health care. This qualitative study explored the perspectives of patients, caregivers and healthcare providers on the use of mHealth tools to support access to and continuity of mental health care in Nigeria. Seventeen participants, including persons with lived experience of depression (n=7), caregivers (n=3), and primary healthcare workers (n=7), were purposively recruited from nine primary health clinics in Ibadan. Interviews were conducted in Yoruba, transcribed, translated into English, and analysed inductively using NVivo 15. Participants identified phone calls, Short Message Service (SMS) reminders, and audiovisual content as key facilitators of engagement, self-care and adherence. Caregivers valued direct communication with providers, while healthcare workers used mobile tools for reminders, follow-up and patient education. Flexible use of next-of-kin contacts helped overcome digital barriers. The findings demonstrate that user-friendly mHealth tools are feasible for supporting mental health care in Nigeria, but their success depends on coupling technology with human-centred communication to ensure equitable and continuous care.

To address challenges in the real-world implementation of digital health for mental healthcare in Nigeria, this study conducted a process evaluation of five World Health Organization-recommended digital tools within a state-wide primary health care program in Lagos. Employing a convergent mixed-methods design across five facilities, we measured implementation fidelity through observation and platform analytics, and assessed stakeholder perceptions via validated surveys and interviews. The findings revealed a sharp divergence in success. Administrative tools that streamlined workflows, such as drug stock notification and automated client reminders, achieved high fidelity (>90% adherence). In contrast, clinical tools that altered provider–patient interactions, including a decision support app and a client helpline, demonstrated low fidelity (<66% adherence). Qualitative analysis attributed this gap to the successful tools’ seamless workflow integration versus the clinical tools’ disruption of practice and introduction of perceived professional and liability risks. The study concludes that digital health adoption is determined less by technological sophistication than by its integration into human systems. Scaling these innovations effectively requires prioritizing tools that align with existing workflows and developing a supportive policy ecosystem to address the professional concerns of frontline health workers.

Digital health services in Kenya comprise mobile health applications (mHealth apps), electronic health records, telehealth and telemedicine, which form part of an expanding digital health assemblage. These are shaped by transnational development agendas and donor-driven public health interventions. This paper discusses the for-profit turn in the digitalisation of health care – what I term the ‘appisation’ of health – as a site of intensified commodification where users are reconfigured as digitised health consumers. While other scholars have argued that digitalisation functions as extractive in deepening market penetration into spheres of life we rely on, I extend these arguments by claiming that, far from enhancing access, these technologies exploit vulnerabilities through opaque governance mechanisms and algorithmic decision-making, while transferring responsibility for health from the state to the individual, thus creating new dependencies on market-mediated platforms. Using discursive interface analysis of two health apps in Kenya, I examine how consumer health apps embed vulnerabilities while consumer law remains structurally limited in confronting the collective harms they generate.

The question of how digital health is regulated has become increasingly important within debates on technology, inequality and global health. While digital health is frequently celebrated for its capacity to expand access, build resilient systems and advance equity, scholars have raised critical concerns about its role in reproducing asymmetries of power. The potential for reproducing rather than curbing inequality is particularly relevant for the Global South. This Special Issue of the International Journal of Law in Context interrogates the ways in which digital health infrastructures, regulatory frameworks and transnational data flows are constitutive of coloniality and neoliberal capitalism. Bringing together socio-legal, feminist and decolonial perspectives, the contributions examine regulation as a terrain in which vulnerabilities, exclusions and structural inequalities are reinforced. Against the celebratory rhetoric of innovation, this collection situates regulation as a key site for understanding the entanglement of digital health with broader histories of coloniality and capitalism.

The promise of digitalisation in achieving Universal Health Coverage in postcolonial contexts is undermined by the realities of insufficiently resourced public healthcare systems. In response, private health insurance is often seen as essential to healthcare delivery. The provision of this private health insurance is increasingly mediated through digital infrastructures, with providers leaning into the promise of data-driven behavioural economics to provide better and more efficient services. While an increasing number of studies focus on digital health, in this paper, we particularly focus on the less-explored question of how datafication – under the veil of shared value, and enabled by forms of legal access – reproduces inequalities. Using the case study of Discovery, a financial services company in South Africa providing health insurance, we analyse how a social value and data-driven behavioural economic model of health insurance commodifies health and wellness. We argue that legal infrastructures are central to this commodification. Through a socio-legal critique of digital health, our article makes an original contribution to broader debates on enduring postcolonial social inequalities by illustrating how infrastructural injustice manifest through datafication.

Individuals with severe mental illness face a significantly reduced life expectancy compared to the general population. Addressing key modifiable risk factors is essential to reduce these alarming rates of mortality in this population. Nutritional psychiatry has emerged as an important field of research, highlighting the important role of nutrition on mental health outcomes. However, individuals with severe mental illness often encounter barriers to healthy eating, including poor diet quality, medication-related side effects such as increased appetite and weight gain, food insecurity and limited autonomy over food choices. While nutrition interventions play a key role in improving health outcomes and should be a standard part of care, their implementation remains challenging. Digital technology presents a promising alternative support model, with the potential to address many of the structural and attitudinal barriers experienced by this population. Nonetheless, issues such as digital exclusion and low digital literacy persist. Integrating public and patient involvement, along with behavioural science frameworks, into the design and delivery of digital nutrition interventions can improve their relevance, acceptability and impact. This review discusses the current and potential role of digital nutrition interventions for individuals with severe mental illness, examining insights, challenges and future directions to inform research and practice.

The high incidence of new cases of anxiety disorders highlights the need for scalable preventive interventions, which can be achieved through information and communication technologies. To our knowledge, no meta-analysis has been conducted to evaluate purely digital preventive interventions for anxiety in all types of populations. The aim of this study was to assess the effectiveness of digital interventions for the prevention of anxiety disorders. Systematic searches were conducted in six electronic databases (PubMed, PsycINFO, EMBASE, Web of Science, OpenGrey, and CENTRAL) from inception to December 12, 2024. Inclusion criteria for the studies were as follows: (1) randomized controlled trials (RCTs), (2) psychological or psychoeducational digital interventions to prevent anxiety, and (3) all types of populations without anxiety at baseline of the study. A total of 15 studies (19 comparisons; 6093 participants) were included in the systematic review. One study was identified as an outlier and was therefore excluded from the meta-analysis. The pooled analysis showed a small effect in favor of preventive interventions among non-anxious and varied populations (standardized mean difference = −0.32, 95% confidence interval: −0.44 to −0.20; p < 0.001). Sensitivity analyses supported the robustness of this finding. We found no evidence of publication bias. Heterogeneity was high, however, a meta-regression that included one variable (country, the Netherlands) explained 100% of the variance. All RCTs, except two, had a high risk of bias, and the quality of the evidence, according to Grading of Recommendations Assessment, Development, and Evaluation, was very low. There is a need to develop and evaluate new digital preventive interventions with a rigorous methodology.

The implementation of electronic health records (EHRs) in mental health contexts has been slow. Reasons for this include concerns from healthcare professionals regarding the collection of sensitive information and the stigma associated with mental health services. Despite the low uptake of EHRs, the benefits include patients feeling empowered and in control of their own treatment. However, ethnically diverse groups often access mental health services through crisis pathways and have been found to disengage with EHRs. The aim of this review was to explore ethnically diverse groups’ perceptions of the utility of mental health EHRs and establish perceived barriers and facilitators to access. MEDLINE, CINAHL, EMBASE, Scopus, PsycINFO, PubMed and Web of Science were searched. Included papers mentioned ethnically diverse groups from the 37 listed countries in the Organisation for Economic Co-operation and Development, and included service users, clients or patients accessing EHRs in mental healthcare settings. Papers were required to be published between 2009 and 2025. Eight papers met all criteria for inclusion, and three themes emerged: language barriers to EHR access, lack of access to technology and perceived impact of EHRs on access to care. Language barriers to EHR access, no access to technology and stigma were significant issues for ethnically diverse groups due to concerns about who has access to the electronic health data. Benefits of accessing EHRs included easier and efficient access to records. EHRs are critical for modern health systems and further work is required to improve EHRs usage in mental health systems for ethnically diverse groups.

In our digital world, reusing data to inform: decisions, advance science, and improve people’s lives should be easier than ever. However, the reuse of data remains limited, complex, and challenging. Some of this complexity requires rethinking consent and public participation processes about it. First, to ensure the legitimacy of uses, including normative aspects like agency and data sovereignty. Second, to enhance data quality and mitigate risks, especially since data are proxies that can misrepresent realities or be oblivious to the original context or use purpose. Third, because data, both as a good and infrastructure, are the building blocks of both technologies and knowledge of public interest that can help societies work towards the well-being of their people and the environment. Using the case study of the European Health Data Space, we propose a multidimensional, polytopic framework with multiple intersections to democratising decision-making and improving the way in which meaningful participation and consent processes are conducted at various levels and from the point of view of institutions, regulations, and practices.